External fixation in fractured patients aged more than 60 years

Fractures account for significant morbidity and mortality among the elderly. Commonly, surgical procedures like internal fixation are not exempt of complications (infection, soft-tissue problems). In this study, we examined the use of external fixation (EF) in 28 patients aged more than 60 years with a total of 30 fractures. There were 16 men and 12 women with a mean age of 72 (61–85) years. The upper limb was involved in four cases and the lower limb in 26. In half of the cases, open fractures were present, which were classified according to Gustilo: eight type I, six type II, and one type III. Fracture healing, angular deviation and bone aspect in the pin site were accessed radiologically. Clinical criteria included fracture healing, pain and articular function. The average time for fracture union was 7 (2–18) months. The overall rate of complications was high (66.6%). The most common complications were malunion (20%), non-union or delayed union (20%) and superficial pin-tract infection (10%). However, severe complications were rare. No deep infection or soft-tissue problems occurred. We consider that EF can be used not only for open and comminuted fractures but also in closed and minimally comminuted fractures with a high risk of soft-tissue problem where no other fixation is suitable.